Almost one million Americans live with Parkinson’s disease, and about 60,000 are diagnosed with it each year.[i] Both men and women develop Parkinson’s disease, though data from the National Institute on Aging[ii] show that it affects about 50% more men than women. Most people develop Parkinson’s disease symptoms around age 60.
Making a Parkinson’s disease diagnosis can be difficult because many of the symptoms initially look like normal aging. That’s why it’s important to report any symptoms to your primary care provider as soon as you notice them.
How early signs of Parkinson’s differ from normal aging
Many early Parkinson’s signs overlap with everyday changes that come with getting older, which is part of what makes them tricky to spot. A tremor can follow too much coffee. Handwriting can shrink with stiff joints. Sleep changes and constipation are common for all sorts of reasons. The key is not any one sign on its own, but a pattern: several signs appearing together, persisting over time, or steadily getting worse. As the Parkinson’s Foundation advises, no single sign should cause alarm, but more than one is worth a conversation with a doctor.
The 10 early warning signs of Parkinson’s disease
Below are the ten signs specialists most often point to. For each, we have included what is generally considered normal, so you can tell the difference more easily.
1. Tremor or shaking at rest
A slight shaking or tremor in a finger, thumb, hand, or chin while the body is at rest is one of the most recognized early signs. A Parkinson’s tremor typically appears when the limb is relaxed and may ease with movement.
What is normal: Shaking can be normal after exercise, during stress, after an injury, or as a side effect of certain medications.
2. Smaller handwriting (micrographia)
If handwriting has suddenly become smaller and more cramped, with letters crowded together, this change is called micrographia and is a common early Parkinson’s sign.
What is normal: Handwriting can change a little with stiff hands, arthritis, or weaker eyesight, especially occasionally rather than consistently.
3. Loss of smell
A reduced ability to smell familiar foods like bananas, licorice, or pickles can appear years before movement symptoms begin. A lasting change in smell, without a clear cause, is worth noting.
What is normal: A cold, the flu, a sinus infection, or a stuffy nose can temporarily dull your sense of smell, which should return as you recover.
4. Trouble sleeping or acting out dreams
Sudden movements during deep sleep, such as thrashing, kicking, or appearing to act out a dream, can be an early sign. A bed partner often notices this first.
What is normal: An occasional restless night is normal, as are quick jerks of the body as you drift off to sleep.
5. Stiffness or trouble moving and walking
Stiffness in the arms, legs, or body that does not ease with movement can be an early sign, especially when paired with a reduced natural arm swing while walking. Loved ones sometimes notice the change in gait first.
What is normal: Stiffness from an injury, arthritis, or a hard workout that improves as you move is usually not a cause for concern.
6. Constipation
Trouble with regular bowel movements can be an early, often overlooked sign, because Parkinson’s can affect the nerves that control digestion before movement symptoms appear.
What is normal: Not drinking enough water, low fiber, or certain medications can cause constipation that resolves once the cause is addressed.
7. A soft or low voice
Speaking more softly, in a quieter or breathier voice, or in a tone that sounds hoarse can be an early sign. Others may often ask you to repeat yourself, even when you feel you are speaking normally.
What is normal: A cold, a sore throat, or other chest or voice conditions can change your voice temporarily.
8. A fixed or serious facial expression (masking)
A serious, depressed, or blank look on the face, even during a relaxed moment, is sometimes called facial masking. It can include staring or blinking less often than usual.
What is normal: Some facial changes come simply from medications, and a tired or focused expression on its own is not unusual.
9. Dizziness or fainting
Feeling dizzy or faint when standing up, on a regular basis, can be linked to the low blood pressure that sometimes accompanies Parkinson’s.
What is normal: Everyone feels lightheaded standing up too quickly once in a while, but if it happens often it is worth checking with a doctor.
10. Stooping or hunched posture
Standing less straight than before, or leaning, stooping, or slouching, can be an early sign. Family and friends sometimes notice this posture change before the person does.
What is normal: Posture can change from an injury, from pain, or from a bone condition, which is different from the gradual stoop linked to Parkinson’s.
Discover how technology can help as you age.
Can I test myself for Parkinson’s disease?
While there’s no home test for Parkinson’s disease, you can check yourself or your loved one’s health against the list of early warning signs above. Report any symptoms to the doctor so they can determine whether the symptoms are Parkinson’s disease, and devise a treatment plan.
Is it Parkinson’s disease or aging?
Only a medical professional can determine whether symptoms indicate Parkinson’s disease, another chronic condition or aging. While the prospect of a Parkinson’s diagnosis may be scary, knowing your health status is vital to successfully managing your wellbeing and staying independent.
Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be experiencing a healthcare condition or medical emergency.
[i] The Parkinson’s Foundation. https://www.parkinson.org/Understanding-Parkinsons/Statistics [ii] National Institutes of Health – National Institute on Aging. Parkinson’s Disease Information Page.
Frequently asked questions
What are the early warning signs of Parkinson’s disease?
Early signs include a slight tremor at rest, smaller handwriting, reduced sense of smell, trouble sleeping, stiffness or slowed movement, constipation, a softer voice, a fixed facial expression, dizziness, and stooped posture. No single sign confirms Parkinson’s, but having more than one is a reason to see a doctor.
What is usually the first sign of Parkinson’s disease?
There is no single first sign that is the same for everyone. A resting tremor is the most recognized early sign, but non-movement signs like loss of smell, constipation, or sleep changes often appear years earlier. The pattern of several signs together matters more than any one.
How is a Parkinson’s tremor different from normal shaking?
A Parkinson’s tremor usually appears when the hand or limb is at rest and may ease with movement, often starting on one side of the body. Ordinary shaking is generally linked to caffeine, stress, fatigue, or medication and is temporary. A persistent resting tremor is worth checking.
Can you have Parkinson’s without a tremor?
Yes. While tremor is common, roughly one in five people with Parkinson’s never develops one. Early signs can instead show as stiffness, slowed movement, loss of smell, sleep changes, or a softer voice. This is why looking at the full pattern of signs matters.
